Abstract
Aims and Objectives: The aim of the study was to compare the effect of complete and partial wound closures on postoperative sequelae and complications after surgical removal of impacted mandibular third molars. Patients and Methods: One hundred and twenty patients who required 121 surgical extractions of mandibular impacted third molars were included in the study. Patients were randomly divided into 2 groups based on wound closure after surgery. In group 1 (complete wound closure, n1 = 60) patients had their extraction sockets completely closed by mucosal flap while in group 2 (partial wound closure, n2 = 60) patients had their extraction sockets partially closed. Data collected included maximum inter-incisal distance (MID) and facial width which were recorded both preoperatively and postoperatively. What also recorded were postoperative pain intensity and postoperative complications. Results: There were 50 (41.7%) males and 70 (58.3%) females (male to female ratio of 1:1.4); age range was 18-40 years and the mean was 26 ± 10 years. The mean ages of patients in both groups showed no significant difference (group 1 = 26.5 ± 7.2; group 2 = 27.1 ± 8.1). The pain was maximal at the first postoperative day review and it gradually reduced in intensity towards the preoperative values for both groups. The pain perceptionsin patients in group 2 were however significantly lower than those of group 1 on days 1 and 3 but not statistically different on day 7. The mean difference in the postoperative and preoperative MID was greatest on the 1st postoperative day and gradually became smaller on the subsequent review days. Comparison of this mean difference between the 2 groups however showed a significant difference in the 2 groups only on day 7. Maximal swelling was noted in both groups on the third postoperative day. A comparison of the mean facial width between the two groups showed no statistically significant difference on all the review days. The postoperative complication rate was 5% in both groups. Conclusions: The results of the study indicate that there was a comparative reduction in postoperative sequelae namely pain and trismus after impacted mandibular third molar surgery when a partial wound closure technique was done. However, there was no significant difference in the postoperative complication rate between the two groups.
Highlights
The surgical objective in impacted mandibular third molar removal is to remove the tooth with minimal sequelae and complications [1,2,3,4]
The mean age of 26 ± 10 years in this study agrees with that of previous researchers that reported extractions of the third molars to be more common in patients in their third decade of life in this environment [7,13,14,15]
Third molar extraction was associated with significant postoperative discomfort but few healing complication
Summary
The surgical objective in impacted mandibular third molar removal is to remove the tooth with minimal sequelae and complications [1,2,3,4]. Various methods have been suggested to prevent or control the postoperative sequelae following third molar surgery. Postoperative pain, swelling, and trismus are acute reversible sequelae of the surgical removal of impacted mandibular third molars. They are generally regarded as short-term outcomes of the third molar impaction sur-. Anighoro et al / Open Journal of Stomatology 3 (2013) 527-532 gery; they are reported to cause a significant deterioration in quality of life and job disruption [5,6] The magnitude of these sequelae depends on the extent of inflammatory response resulting from the extent of tissue damage produced [5]. This study is intended to contribute to such knowledge by comparing the extent of postoperative sequelae that follow lower third molar surgery in our environment using the two methods of closure
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